POS1387-HPR THE IMPACT OF PSYCHOEMOTIONAL MOOD DISORDERS ON MUSCULOSKELETAL PAIN IN PATIENTS WITH INFLAMMATORY JOINT DISEASES
Authors: S. Bogdanova-Petrova, T. Shivacheva, T. Georgiev, S. Dimitrov, R. Moraliyska, S. Hristova, G. Gerganov, M. Dimova-Mileva, P. Petrov
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Chronic inflammatory joint diseases such as rheumatoid arthritis (RA), ankylosing spondylitis (AS) and psoriatic arthritis (PsA) are most common rheumatic diseases that may cause musculoskeletal pain [1]. The genesis of pain is very complex and many different mechanisms are involved. It is the result of multiple biochemical reactions and is influenced to varying degrees by biological, physiological and social factors. (2) The presence of pain is largely determined by the inflammatory activity of the underlying disease, but subjective factors that depend on the psycho-emotional state of the patient are involved in the assessment of the severity of pain symptoms [3]. <h3>Objectives</h3> The aim of the study is to assess the intensity of musculoskeletal pain - arthralgia and myalgia and its correlation with anxiety and depressive mood disorders among a Bulgarian cohort of patients with chronic inflammatory diseases. <h3>Methods</h3> A single-center, observational study including patients with RA, AS and PsA, dispensary in the Rheumatology clinic, "St. Marina" UMBAL - Varna. All the patients were diagnosed according to the criteria for the specific inflammatory joint disease and were treated with a biological medication. Visual analogue scales (VAS) to assess pain intensity (muscular and joint) and Zung self-report scales for depression (SDS) and anxiety (SAS) were used. Laboratory acute phase indicators were investigated in all patients. Descriptive statistics, one-Sample T test, correlation and linear regression analyses were used. A significance level of p&lt;0.01 was accepted. <h3>Results</h3> 130 patients with inflammatory joint disease (RA, AS, PsA), were included in the study. The average age of the study population was 56.37 years (from 21-76 years). 41.5% (n=54) of them were women, 58.5% (n=76) were men. No significant differences were found in evaluating the visual-analog scales for assessing joint and muscle pain between men and women (р=0.177 for joint pain and р=0.717 for muscular pain). On the other hand women scored higher on the anxiety and depression scales, and the difference was again significant (p&lt;0.001 for the depression scale and p=0.001 for the anxiety scale). The self-assessment on the depression scale (SDS) shows a significant correlation with the self-assessment of muscle and joint pain, but the self-reported anxiety scale (SAS) showed a significant correlation only with the self-reported joint pain (SDS and VASm, p=0.008; SDS and VASa, p&lt;0.001; SAS and VASm, p=0.031, SAS and VASa, p=0.004 respectively). Inflammatory indicators (predictors) determine about 8% of the variation of the two pain indicators - for joint pain - R square 7.8%, for muscle pain - R square 8.1% <h3>Conclusion</h3> Musculoskeletal pain is one of the most common clinical presentations of inflammatory join diseases. Chronic pain can lead to mood disorder. The intensity of the pain correlates with anxiety and depressive symptoms in these patients. <h3>References</h3> [1]Salaffi, F., Carotti, M., Gasparini, S. et al. The health-related quality of life in rheumatoid arthritis, ankylosing spondylitis, and psoriatic arthritis: a comparison with a selected sample of healthy people. Health Qual Life Outcomes 7, 25 (2009) [2]Omoigui S. The biochemical origin of pain: the origin of all pain is inflammation and the inflammatory response. Part 2 of 3 - inflammatory profile of pain syndromes. Med Hypotheses. 2007;69(6):1169-78 [3]Meints SM, Edwards RR. Evaluating psychosocial contributions to chronic pain outcomes. Prog Neuropsychopharmacol Biol Psychiatry. 2018 Dec 20;87(Pt B):168-182 <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.